Margaret has an emergency medical condition, goes to the hospital, and then to a nursing home for rehabilitation. Along the way she loses her job, her car, her apartment, her meager savings, and ends up on Medi-Cal (California’s Medicaid program). Her medical condition improves and she is capable of moving back to the community, provided services are packaged around her. But, with no family to take her in, she has no place to go. Neither Medicare nor Medi-Cal pays for assisted living. Today Margaret is still in the nursing home, and longs to “get her life back”. Remaining in the nursing home costs Medi-Cal about $6,000 a month, but home health services could be provided at closer to $3,000 per month.
Lamar Turner, development consultant, founder of EderFocus, and passionate about giving equitable opportunities to low income seniors, wants to solve this situation and sees it as one of the levers for bringing together the health care industry and housing industry both in the private sector of affordable housing and in public housing.
He presented his ideas and led a discussion at the AHWGO ‘round table’ in January to participants from social services, development and design, who were all deeply engaged and invested in exploring solutions for their clients and for themselves. Lamar made it clear that any solution has to be financially sustainable – “if you cannot pay for it you cannot build it”. The challenge is to find ways to distribute the benefits. Health care cost savings from such a solution could be used to develop new funding sources for the starved housing industry.
The key to promoting such integration of home and health with the potential for replication and standardization is data and empirical research. Lamar’s route for an integrated model, the Assisted Living Waver Program (ALW) provides funding to pay for services for those nursing home residents who have the potential to live independently with care support in appropriate housing. Unfortunately, the ALW program does not pay for housing costs. Solid research documenting health care savings would provide much needed data to ‘scale up’ aging in place for our lower income older adults.
Lamar is currently working on establishing a number of pilot projects in existing affordable housing residences utilizing the Assisted Living Waiver Program. The longer term goal is to generate a reliable and ongoing pipeline of funding, both for new construction and operating subsidy that will enable lower income older adults to remain in their home and community as they age.

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